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Journal of Clinical Medicine Jun 2024: This study evaluates the diagnostic accuracy of an AI-assisted tool in assessing the proximity of the mandibular canal (MC) to the root apices (RAs) of mandibular...
: This study evaluates the diagnostic accuracy of an AI-assisted tool in assessing the proximity of the mandibular canal (MC) to the root apices (RAs) of mandibular teeth using computed tomography (CT). : This study involved 57 patients aged 18-30 whose CT scans were analyzed by both AI and human experts. The primary aim was to measure the closest distance between the MC and RAs and to assess the AI tool's diagnostic performance. The results indicated significant variability in RA-MC distances, with third molars showing the smallest mean distances and first molars the greatest. Diagnostic accuracy metrics for the AI tool were assessed at three thresholds (0 mm, 0.5 mm, and 1 mm). : The AI demonstrated high specificity but generally low diagnostic accuracy, with the highest metrics at the 0.5 mm threshold with 40.91% sensitivity and 97.06% specificity. : This study underscores the limited potential of tested AI programs in reducing iatrogenic damage to the inferior alveolar nerve (IAN) during dental procedures. Significant differences in RA-MC distances between evaluated teeth were found.
PubMed: 38930132
DOI: 10.3390/jcm13123605 -
Life (Basel, Switzerland) Jun 2024High-quality echocardiogram images are the cornerstone of accurate and reliable measurements of the heart. Therefore, this study aimed to develop, validate and compare...
High-quality echocardiogram images are the cornerstone of accurate and reliable measurements of the heart. Therefore, this study aimed to develop, validate and compare machine learning and deep learning algorithms for accurate and automated assessment of transthoracic echocardiogram image quality. In total, 4090 single-frame two-dimensional transthoracic echocardiogram images were used from apical 4-chamber, apical 2-chamber and parasternal long-axis views sampled from 3530 adult patients. The data were extracted from CAMUS and Unity Imaging open-source datasets. For every raw image, additional grayscale block histograms were developed. For block histogram datasets, six classic machine learning algorithms were tested. Moreover, convolutional neural networks based on the pre-trained EfficientNetB4 architecture were developed for raw image datasets. Classic machine learning algorithms predicted image quality with 0.74 to 0.92 accuracy (AUC 0.81 to 0.96), whereas convolutional neural networks achieved between 0.74 and 0.89 prediction accuracy (AUC 0.79 to 0.95). Both approaches are accurate methods of echocardiogram image quality assessment. Moreover, this study is a proof of concept of a novel method of training classic machine learning algorithms on block histograms calculated from raw images. Automated echocardiogram image quality assessment methods may provide additional relevant information to the echocardiographer in daily clinical practice and improve reliability in clinical decision making.
PubMed: 38929743
DOI: 10.3390/life14060761 -
Medicina (Kaunas, Lithuania) May 2024In teeth with open apices, performing single session apexification is a challenging treatment due to the difficulty in handling mineral trioxide aggregate (MTA)....
In teeth with open apices, performing single session apexification is a challenging treatment due to the difficulty in handling mineral trioxide aggregate (MTA). Minimally invasive approaches in dentistry have also influenced the cavity designs in endodontics. Until now, different techniques have not been investigated in addition to manual condensation during the process of placing MTA in traditional (TradACs) or conservative (ConsACs) endodontic access cavities. The aim of this in vitro study was to compare and evaluate the obturation quality of MTA apical plugs placed with different techniques in TradACs or ConsACs. : Sixty upper central teeth were divided into two main groups based on cavity design, and then each main group was further divided into three subgroups according to MTA placement techniques ( = 10): TradAC-manual, TradAC-manual + indirect ultrasonic activation, TradAC-manual + XP-endo Shaper (XPS), ConsAC-manual, ConsAC-manual + indirect ultrasonic activation, and ConsAC-manual + XPS. Subsequently, the porosity percentages in the MTA apical plug were analyzed using micro-computed tomography. The statistical analysis was performed using the Kruskal-Wallis H test and Mann-Whitney test. Statistical significance was set at < 0.05. There were differences in volume of porosity percentages (%) according to cavity designs and MTA application techniques ( < 0.05). Except for the XPS group, more porosity was observed in ConsACs compared to TradACs. In TradACs, the significantly lowest open and total porosity was observed in the manual, ultrasonic, and XPS techniques, respectively. In ConsACs, the significantly lowest porosity was observed in the manual, XPS, and ultrasonic techniques, respectively ( 0.05). In MTA obturation, cavity designs and application techniques had an impact on the MTA porosity. Creating an apical plug in ConsACs may result in more porosity compared to TradACs, especially when manual or indirect ultrasonic activation is preferred. Opting for the manual technique alone may be considered sufficient for controlling porosity for both TradACs and ConsACs.
Topics: Calcium Compounds; Aluminum Compounds; Drug Combinations; Silicates; Humans; Oxides; X-Ray Microtomography; Root Canal Obturation; Root Canal Filling Materials; In Vitro Techniques
PubMed: 38929495
DOI: 10.3390/medicina60060878 -
International Journal of Molecular... Jun 2024Cystic fibrosis (CF), also known as mucoviscidosis, is the most common autosomal recessive genetic disease in the Caucasian population, with an estimated frequency of... (Review)
Review
Cystic fibrosis (CF), also known as mucoviscidosis, is the most common autosomal recessive genetic disease in the Caucasian population, with an estimated frequency of 1:2000-3000 live births. CF results from the mutation of the cystic fibrosis transmembrane conductance regulator (CFTR) gene localized in the long arm of chromosome 7. The product of CFTR gene expression is CFTR protein, an adenosine triphosphate (ATP)-binding cassette (ABC) transporter that regulates the transport of chloride ions (Cl) across the apical cell membrane. Primary manifestations of CF include chronic lung and pancreas function impairment secondary to the production of thick, sticky mucus resulting from dehydrated secretions. It is well known that CF can cause both anterior and posterior ocular abnormalities. Conjunctival and corneal xerosis and dry eye disease symptoms are the most characteristic manifestations in the anterior segment. In contrast, the most typical anatomical and functional changes relating to the posterior segment of the eye include defects in the retinal nerve fiber layer (RNFL), vascular abnormalities, and visual disturbances, such as reduced contrast sensitivity and abnormal dark adaptation. However, the complete background of ophthalmic manifestations in the course of CF has yet to be discovered. This review summarizes the current knowledge regarding ocular changes in cystic fibrosis.
Topics: Humans; Cystic Fibrosis; Cystic Fibrosis Transmembrane Conductance Regulator; Eye Diseases; Mutation; Animals
PubMed: 38928397
DOI: 10.3390/ijms25126692 -
Biomedicines Jun 2024The aim of this study was to assess the importance of T1-mapping sequences in the diagnosis of hypertrophic cardiomyopathy (HCM) in patients without foci of non-ischemic...
BACKGROUND
The aim of this study was to assess the importance of T1-mapping sequences in the diagnosis of hypertrophic cardiomyopathy (HCM) in patients without foci of non-ischemic myocardial injury in classic cardiac magnetic resonance (CMR) sequences.
METHODS
Two groups were compared: 28 patients with HCM, without any foci of myocardial injury in the late gadolinium enhancement (LGE) sequence (HCM group), and 28 patients without cardiomyopathy (CON group). Classic CMR sequences and T1-mapping sequences were performed. The following parameters were assessed: T1 time of the whole left ventricular myocardium, T1 time of myocardium in the basal, middle and apical layers of the left ventricle, and T1 time in individual segments of the left ventricular myocardium. Myocardial extracellular volume (ECV) was assessed similarly.
RESULTS
ECV was significantly higher in the HCM group than in the CON group, for the whole left ventricular myocardium, for the basal and apical layers of the left ventricle, and for segments 1-3, 8, and 13-16 of the left ventricle. Regression analysis showed that a higher left-ventricular mass index (LVMI), a higher body mass index and older age are factors independently associated with a higher ECV of the whole myocardium but only in the group with LVMI ≥ 131.84 g/m.
CONCLUSION
In patients with HCM without foci of non-ischemic myocardial injury, higher ECV values of the left ventricular myocardium are observed.
PubMed: 38927537
DOI: 10.3390/biomedicines12061330 -
Biomedicines Jun 2024head formation depends on an organizing center in which Wnt/β-catenin signaling, that plays an inductive role, positively regulates and , with Sp5 limiting...
head formation depends on an organizing center in which Wnt/β-catenin signaling, that plays an inductive role, positively regulates and , with Sp5 limiting expression and Zic4 triggering tentacle formation. Using transgenic lines in which the promoter drives eGFP expression in either the epidermis or gastrodermis, we show that promoter activity is differentially regulated in each epithelial layer. In intact animals, epidermal GFP activity is strong apically and weak along the body column, while in the gastrodermis, it is maximal in the tentacle ring region and maintained at a high level along the upper body column. During apical regeneration, :GFP is activated early in the gastrodermis and later in the epidermis. Alsterpaullone treatment induces a shift in apical expression towards the body column where it forms transient circular figures in the epidermis. Upon (RNAi), GFP activity is down-regulated in the epidermis while bud-like structures expressing GFP in the gastrodermis develop. (RNAi) reveals a negative autoregulation in the epidermis, but not in the gastrodermis. These differential regulations in the epidermis and gastrodermis highlight the distinct architectures of the network in the hypostome, tentacle base and body column of intact animals, as well as in the buds and apical and basal regenerating tips.
PubMed: 38927481
DOI: 10.3390/biomedicines12061274 -
Journal of Cardiothoracic Surgery Jun 2024Multiportal video-assisted thoracic surgery (mVATS) is the standard approach for the surgical treatment of spontaneous pneumothorax. However, uniportal VATS (uVATS) has... (Comparative Study)
Comparative Study
BACKGROUND
Multiportal video-assisted thoracic surgery (mVATS) is the standard approach for the surgical treatment of spontaneous pneumothorax. However, uniportal VATS (uVATS) has emerged as an alternative aiming to minimize surgical morbidity. This study aims to strengthen the evidence on the safety and efficiency of uVATS compared to mVATS.
METHODS
From January 2004 to December 2020, records of patients who had undergone surgical treatment for primary or secondary spontaneous pneumothorax were evaluated for eligibility. Patients who had undergone pleurectomy combined with bullectomy or apical wedge resection via uVATS or mVATS were included. Surgical characteristics and postoperative data were compared between patients who had undergone surgery via uVATS or mVATS. Univariable and multivariable analyses were performed to determine whether the surgical approach was associated with any complication (primary outcome), major complications (i.e., Clavien-Dindo ≥ 3), recurrence, prolonged hospitalization or prolonged chest drainage duration (secondary outcomes).
RESULTS
A total of 212 patients were enrolled. Patients treated via uVATS (n = 71) and mVATS (n = 141) were significantly different in pneumothorax type (secondary spontaneous; uVATS: 54 [76%], mVATS: 79 [56%]; p = 0.004). No significant differences were observed in (major) complications and recurrence rates between both groups. Multivariable analyses revealed that the surgical approach was no significant predictor for the primary or secondary outcomes.
CONCLUSIONS
This study indicates that uVATS is non-inferior to mVATS in the surgical treatment of spontaneous pneumothorax regarding safety and efficiency, and thus the uVATS approach has the potential for further improvements in the perioperative surgical care for spontaneous pneumothorax.
Topics: Humans; Pneumothorax; Thoracic Surgery, Video-Assisted; Male; Female; Adult; Retrospective Studies; Treatment Outcome; Postoperative Complications; Middle Aged
PubMed: 38926766
DOI: 10.1186/s13019-024-02931-4 -
BMC Oral Health Jun 2024The purpose of this study was to investigate the morphology of maxillary first premolar mesial root concavity and to analyse its relation to periodontal bone loss (BL)...
BACKGROUND
The purpose of this study was to investigate the morphology of maxillary first premolar mesial root concavity and to analyse its relation to periodontal bone loss (BL) using cone beam computed tomography (CBCT) and panoramic radiographs.
METHODS
The mesial root concavity of maxillary premolar teeth was analysed via CBCT. The sex and age of the patients, starting position and depth of the root concavity, apicocoronal length of the concavity on the crown or root starting from the cementoenamel junction (CEJ), total apicocoronal length of the concavity, amount of bone loss both in CBCT images and panoramic radiographs, location of the furcation, length of the buccal and palatinal roots, and buccopalatinal cervical root width were measured.
RESULTS
A total of 610 patients' CBCT images were examined, and 100 were included in the study. The total number of upper premolar teeth was 200. The patients were aged between 18 and 65 years, with a mean age of 45.21 ± 13.13 years. All the teeth in the study presented mesial root concavity (100%, n = 200). The starting point of concavity was mostly on the cervical third of the root (58.5%). The mean depth and buccolingual length measurements were 0.96 mm and 4.32 mm, respectively. Depth was significantly related to the amount of alveolar bone loss (F = 5.834, p = 0.001). The highest average concavity depth was 1.29 mm in the group with 50% bone loss. The data indicated a significant relationship between the location of the furcation and bone loss (X = 25.215, p = 0.003). Bone loss exceeded 50% in 100% of patients in whom the furcation was in the cervical third and in only 9.5% of patients in whom the furcation was in the apical third (p = 0.003).
CONCLUSIONS
According to the results of this study, the depth of the mesial root concavity and the coronal position of the furcation may increase the amount of alveolar bone loss. Clinicians should be aware of these anatomical factors to ensure accurate treatment planning and successful patient management.
Topics: Humans; Bicuspid; Cone-Beam Computed Tomography; Male; Female; Alveolar Bone Loss; Tooth Root; Adult; Middle Aged; Adolescent; Maxilla; Aged; Young Adult; Radiography, Panoramic; Tooth Cervix
PubMed: 38926720
DOI: 10.1186/s12903-024-04494-1 -
European Spine Journal : Official... Jun 2024To validate a fast 3D biplanar spinal radiograph reconstruction method with automatic extract curvature parameters using artificial intelligence (AI).
PURPOSE
To validate a fast 3D biplanar spinal radiograph reconstruction method with automatic extract curvature parameters using artificial intelligence (AI).
METHODS
Three-hundred eighty paired, posteroanterior and lateral, radiographs from the EOS X-ray system of children with adolescent idiopathic scoliosis were randomly selected from the database. For the AI model development, 304 paired images were used for training; 76 pairs were employed for testing. The validation was evaluated by comparing curvature parameters, including Cobb angles (CA), apical axial vertebral rotation (AVR), kyphotic angle (T1-T12 KA), and lordotic angle (L1-L5 LA), to manual measurements from a rater with 8 years of scoliosis experience. The mean absolute differences ± standard deviation (MAD ± SD), the percentage of measurements within the clinically acceptable errors, the standard error of measurement (SEM), and the inter-method intraclass correlation coefficient ICC were calculated. The average reconstruction speed of the 76 test images was recorded.
RESULTS
Among the 76 test images, 134 and 128 CA were exported automatically and measured manually, respectively. The MAD ± SD for CA, AVR at apex, KA, and LA were 3.3° ± 3.5°, 1.5° ± 1.5°, 3.3° ± 2.6° and 3.5° ± 2.5°, respectively, and 98% of these measurements were within the clinical acceptance errors. The SEMs and the ICC for the compared parameters were all less than 0.7° and > 0.94, respectively. The average time to display the 3D spine and report the measurements was 5.2 ± 1.3 s.
CONCLUSION
The developed AI algorithm could reconstruct a 3D scoliotic spine within 6 s, and the automatic curvature parameters were accurately and reliably extracted from the reconstructed images.
PubMed: 38926172
DOI: 10.1007/s00586-024-08375-7 -
Nephrology (Carlton, Vic.) Jun 2024Bile acids (BA) function as signalling molecules regulating glucose-lipid homeostasis and energy expenditure. However, the expression of the apical sodium-dependent bile...
AIM
Bile acids (BA) function as signalling molecules regulating glucose-lipid homeostasis and energy expenditure. However, the expression of the apical sodium-dependent bile acid transporter (ASBT) in the kidney, responsible for renal BA reabsorption, is downregulated in patients with diabetic kidney disease (DKD). Using the db/db mouse model of DKD, this study aimed to investigate the effects of rescuing ASBT expression via adeno-associated virus-mediated delivery of ASBT (ASBT) on kidney protection.
METHODS
Six-week-old male db/db mice received an intraparenchymal injection of ASBT at a dose of 1 × 10 viral genomes (vg)/animal and were subsequently fed a chow diet for 2 weeks. Male db/m mice served as controls. For drug treatment, daily intraperitoneal (i.p.) injections of the farnesoid X receptor (FXR) antagonist guggulsterone (GS, 10 mg/kg) were administered one day after initiating the experiment.
RESULTS
ASBT treatment rescued renal ASBT expression and reduced the urinary BA output in db/db mice. ASBT treatment activated kidney mitochondrial biogenesis and ameliorated renal impairment associated with diabetes by activating FXR. In addition, the injection of FXR antagonist GS in DKD mice would reverse these beneficial effects by ASBT treatment.
CONCLUSION
Our work indicated that restoring renal ASBT expression slowed the course of DKD via activating FXR. FXR activation stimulates mitochondrial biogenesis while reducing renal oxidative stress and lipid build up, indicating FXR activation's crucial role in preventing DKD. These findings further suggest that the maintenance of renal BA reabsorption could be a viable treatment for DKD.
PubMed: 38925891
DOI: 10.1111/nep.14338